Revenue Cycle Manager

EDGEWATER HEALTH-posted 1 day ago

Full-time • Manager

Onsite • Gary, IN

51-100 employees

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The Revenue Cycle Manager is responsible for the oversight, management, and optimization of the organization’s revenue cycle operations, including billing, collections, accounts receivable, and payer relations. This position ensures that all financial transactions related to patient services are executed accurately, efficiently, and in compliance with federal, state, and payer regulations. The Revenue Cycle Manager works collaboratively with clinical, administrative, and finance leadership to support the organization’s mission of providing high-quality primary care, addictions treatment, and mental health services while maintaining financial sustainability. This position is based entirely on-site at our main facility in Gary, IN. Remote work is not available.

Oversee all aspects of the revenue cycle, including patient registration, charge capture, coding, billing, claims submission, payment posting, and collections.
Monitor and evaluate performance indicators such as accounts receivable aging, denial rates, and collection ratios to ensure efficient cash flow and revenue optimization.
Develop and implement policies and procedures to support compliant and efficient revenue cycle operations.
Coordinate with clinical and administrative departments to ensure proper documentation and charge capture for services across all programs (primary care, behavioral health, and substance use treatment).
Analyze and resolve reimbursement issues, denials, and underpayments; lead root cause analyses to prevent recurrence.
Maintain current knowledge of payer requirements, billing regulations, and compliance standards (Medicare, Medicaid, Managed Care, and other third-party payers).
Collaborate with the Compliance Officer to ensure adherence to HIPAA, OIG, and CMS guidelines.
Prepare monthly, quarterly, and annual reports on revenue performance and key financial indicators for executive leadership.
Lead, train, and supervise billing and revenue cycle staff, fostering a culture of accountability, collaboration, and continuous improvement.
Partner with IT and EHR teams to ensure billing and reporting systems function effectively and support workflow efficiency.
Participate in annual audits, grant reporting, and financial reviews as requested.
Support the organization’s mission and values through ethical financial practices and a focus on patient-centered service delivery.
Perform other duties as assigned

Education- bachelor’s degree in healthcare administration, finance, accounting, business, or related field required.
Experience- Minimum of five years of progressive experience in healthcare revenue cycle management required.
Demonstrated knowledge of CPT/ICD-10 coding, payer rules, and managed care reimbursement.
Experience with Medicaid, Medicare, and managed care billing and reimbursement required.

Strong leadership and team building skills.
Excellent analytical, problem solving, and decision-making abilities.
In-depth knowledge of payer contracting, claims processing, and reimbursement methodologies.
Effective communication and interpersonal skills to work collaboratively across departments.
Ability to manage multiple priorities and meet deadlines in a fast-paced healthcare environment.
High degree of integrity, professionalism, and commitment to confidentiality.
Master’s degree preferred.
Experience in behavioral health, primary care, or substance use treatment billing strongly preferred.
Familiarity with value-based payment models and integrated care billing preferred.

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